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Types of vaginal cancer

The type of vaginal cancer depends on the type of cell that the cancer developed from. To find this out, a pathologist looks at a sample of cancer tissue (biopsy) under a microscope.

Squamous cell vaginal cancer

More than 8 out of 10 (80%) vaginal cancers are squamous cell cancers. This type of cancer usually grows slowly over many years. Before squamous cell cancer develops, there may be precancerous changes to the cells. This is called vaginal intraepithelial neoplasia, or VAIN.

Verrucous carcinoma is a rare type of squamous cell vaginal cancer. It is a slow growing tumour that rarely spreads to other parts of the body.

Adenocarcinoma of the vagina

Around 1 in 10 vaginal cancers (10%) are adenocarcinomas. It is sometimes difficult for doctors to tell whether this type of cancer started in the vagina, or in a nearby organ and then spread. There are 4 main types of adenocarcinoma of the vagina – clear cell adenocarcinoma, papillary adenocarcinoma, mucinous adenocarcinoma and adenosquamous carcinoma.

Other types of vaginal cancer

Other types of vaginal cancer are very rare. They include sarcomas of the vagina, melanomas of the vagina and small cell vaginal cancer.

The different types of vaginal cancer

There are different types of vaginal cancer because the vagina is made of several different types of body tissues. The type of cancer you have depends on the specific type of cell that the cancer developed from. To find this out, your doctor takes a tissue sample (biopsy) from the cancer. They send the sample to a laboratory. A pathologist looks at the cells in the sample under a microscope. The cells of the different types of vaginal cancer look different.

Squamous cell carcinoma and adenocarcinoma of the vagina are the most common types and most of the information in this section refers to them. Other types of vaginal cancer are very rare but there are small amounts of information about these.

Squamous cell carcinoma (the most common type)

This is by far the most common type of vaginal cancer. More than 8 out of 10 (80%) vaginal cancers are this type. Squamous cell cancers are most likely in the upper third of the vagina, closest to the cervix. Squamous cells are the flat, skin like cells that cover the surface of the vagina. This type of cancer usually grows slowly over many years. The tumours look like small lumps (nodules) or sores (ulcers).

Verrucous carcinoma is a rare type of squamous cell vaginal cancer. It looks like a large wart and is a slow growing tumour that rarely spreads to other parts of the body. It is usually curable with surgery.

Adenocarcinoma of the vagina

This is much rarer than squamous cell vaginal cancer. Around 1 in 10 vaginal cancers (10%) are this type. Adenocarcinoma means that the cancer started in the gland cells (adenomatous cells) in the lining of the vagina. The gland cells produce mucus.

This type of vaginal cancer is harder to diagnose than squamous cell cancer. The cancer is more likely to be hidden inside the vaginal canal. It is sometimes difficult for doctors to tell whether this type of cancer started in the vagina, or started in a nearby organ and then spread into the vagina. This type of vaginal cancer can occur in young women.

Clear cell cancer is a rare type of adenocarcinoma of the vagina. This only occurs in young women whose mothers took a drug called diethylstilbestrol (DES) when they were pregnant. These cancers usually look like polyps. It can occur in women in their teens and 20s. As it is now more than 35 years since DES was used in pregnancy, these cancers are becoming even rarer.

Adenosquamous cancers of the vagina are made up of a combination of squamous cells and gland cells. This type of cancer is often called a mixed epithelial tumour. They are very rare, but are often quickly growing tumours. Only between 1 and 2 out of every 100 women (1 to 2%) with vaginal cancer have an adenosquamous cancer.

Sarcoma of the vagina

Sarcomas are cancers that start in the body’s connective tissues – the tissues that form the structure of the body, such as bone, muscle, fat and cartilage. Sarcomas of the vagina are extremely rare and account for only about 3 out of every 100 vaginal cancers (3%). These cancers tend to grow quite quickly. Different types of sarcoma can start in the vagina, including leiomyosarcoma and rhabdomyosarcoma. These are both muscle tumours. About two thirds of vaginal sarcomas are leiomyosarcomas. It is possible to have other types of sarcoma, such as mixed Mullerian sarcoma, but these are extremely rare.

Embryonal rhabdomyosarcoma (also called sarcoma botryoides) is a very rare type of vaginal sarcoma. It only develops in girls up to the age of 6 years. It is usually recognised by soft nodules that fill the vagina and sometimes show outside the vagina. They look a bit like bunches of grapes. This is a very quickly growing cancer and is difficult to treat. But the outcome for girls with this cancer is getting better with an intensive combination of treatment including surgery, chemotherapy and radiotherapy.

Melanoma of the vagina

Only about 3 out of every 100 vaginal cancers (3%) are melanoma (vaginal melanoma). Melanomas develop from the cells in the skin that produce pigment, which gives the skin its colour. Melanoma is most likely to develop in the lower third of the vagina and in women in their 50’s. But doctors have recorded cases in women as young as 22 and as old as 83.

Small cell vaginal cancer

Small cell cancers are also called oat cell carcinoma. It is called this because the cancer cells are a distinctive oat shape. They are very, very rare. Doctors worldwide have reported fewer than 20 cases of this type of vaginal cancer.

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